Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Hansard source

I rise today to speak on the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025. The opposition will support this bill because the bill seeks to implement a suite of measures designed to protect the integrity of Medicare, strengthen the regulation of goods under the Therapeutic Goods Act and introduce minor but necessary amendments to the tobacco act.

These changes form part of the government's response to the Independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip. Dr Philip's review revealed serious issues in the administration of our health benefits scheme, particularly in the ability to detect, investigate and respond to fraud, misconduct and noncompliance within Medicare and associated schemes. The bill takes some practical steps to improve that situation. It seeks to provide the department with the tools necessary to carry out timely, efficient and effective compliance activities—measures that are essential to maintaining the public's trust and confidence in the Medicare system and ensuring taxpayers' funds are spent and used appropriately and wisely. I also note that the Senate inquiry into this bill, which reported during the recent caretaker period, has recommended the passage of this bill.

For these reasons, the coalition will be supporting those recommendations, because we've long championed the need for strong and fair compliance within Medicare and other critical programs like the Pharmaceutical Benefits Scheme and the child dental benefits scheme. We believe that preserving the integrity of these systems is fundamental in delivering a sustainable and equitable healthcare system for all Australians.

However, while we support this bill and the improvements it seeks to deliver, we must also confront the broader and deeply concerning reality of Medicare under the Albanese Labor government. Labor promised at the last election in 2022 that they would strengthen Medicare, but since they've come to power we have seen the complete opposite. Bulk-billing rates have collapsed. When we left government and Labor was elected in 2022, over 88 per cent of appointments were bulk-billed. In just three years, that number had dropped by 11 per cent, to 77 per cent, under the first term of the Albanese Labor government. An 11 per cent decline is quite a staggering thing, and it meant that we saw 40 million fewer bulk-billed GP visits in the last year alone.

Worse still, Australians are now paying 45 per cent more in out-of-pocket costs than they were just a few years ago. Last year, 1.5 million Australians said they did not see their doctor because they could not afford to do so. That is 1.5 million Australians who potentially will become sicker because they have not had the early intervention that they needed—and guess where they end up? They end up in the emergency departments of our hospitals, which are already overburdened, with ramping at some of the worst levels ever seen on record and continuing to get worse in just about every state or territory in the country.

These aren't just abstract figures being put out here by the opposition; these facts and figures are contained in reports of the government itself. More importantly, these facts, figures and statistics relate to real people, real Australians, who are having to make the difficult decision between putting food on the table and going to see their doctor. As I said, these figures come from the government's very own national accounts. This is a crisis in our primary care system that has occurred under the watch of the Albanese Labor government in the last three years.

But what do we see the Prime Minister do when he turns up at the election in 2025? We see him waving his Medicare card around and using it as a political prop—a disingenuous stunt to try to distract Australians from his track record whilst in government for the last three years. This is absolutely not leadership. It is dishonesty and spin to try to con Australians into believing the situation is not as dire as it really is, and it has become completely and utterly catastrophic under the reign of this Labor government. It's a betrayal of the promise that Labor made to Australians—and keeps on making despite the facts telling a completely different story.

The coalition, on the other hand, is absolutely committed—totally and utterly committed—to making sure that Australians get affordable and timely access to health care. That should be, fundamentally, the thing that underpins our healthcare system in Australia, and that principle is what guided us the whole time we were in government. It guided us when we were continuing to list new medicines on the PBS—2,900 new or amended listings while we were in government. The last time the Labor Party were in government, between 2007 and 2013, they stopped listing medicines because they ran out of money. In the last term of the last Labor government, they decided to put a cap on the number of medicines listed under the PBS—a sneaky way to stop listing medicines on the PBS.

The coalition is absolutely committed to Australians getting access to timely and affordable quality health care. It guided us in government, and it will continue to guide us in opposition. We support the passage of this bill because it is taking important steps towards maintaining the strength, compliance and integrity of our Medicare system. It is so important that we maintain the strength and integrity of our public health systems, because that is what underpins the strong health system that we deserve in this country.

But let's be clear that this bill alone does not fix the mess that this government has created in Medicare. It does not address the affordability crisis that is making Australians pay ever more out-of-pocket costs every time they go to see the doctor. This bill does nothing to try to meet the promises made by this Prime Minister at successive elections about Australians being able to access affordable and timely health care, and it does not address the fact that he told Australians that the only card they would need when they went to the doctor was their Medicare card. Let's be clear: Australians know that that's not the case, because they feel it every time they go to see the doctor. They feel it in their hip pocket. They don't just hand over their Medicare card; they have to hand over their credit card as well. So, despite what the Prime Minister might say, the truth of what is actually happening out on the ground is something that Australians are feeling every day.

As I said, whilst this bill does very little to address the broader issues that are facing our healthcare system in this country as we stand here, we will support this bill because it does go some way to improving issues around the integrity and strength of our Medicare system. We will continue to scrutinise every piece of legislation that comes in here in relation to health. We will make sure we hold the government to account for the promises that it has made to the Australian public—promises that, sadly, we don't believe it will be able to deliver, even though we would love to see a situation where Australians are actually getting affordable and timely access to health care. We will hold them to account and we will continue to speak up for the millions and millions of Australians who have been let down by this government, who are paying the highest out-of-pocket costs that they have ever paid, who are having trouble getting access to even get in to see the GP, and who are ramped at the moment or are having to attend our emergency departments because they simply can't afford to see a GP. We will continue to fight on their behalf because we believe that they deserve affordable and timely access to health care.